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CIRCULAR No

CIRCULAR No. 02/2004/TT-BYT OF JANUARY 20, 2004 GUIDING THE WORK OF HEALTHCARE FOR ELDERLY PEOPLE

Pursuant to Articles 14, 15 and 16 of Ordinance No. 23/2000/PL-UBTVQH of April 28, 2000 on Elderly People, on assigning tasks to the health service;

Pursuant to the Government’s Decree No. 30/2002/ND-CP of March 26, 2002 prescribing and guiding the implementation of a number of articles of the Ordinance on Elderly People;

Pursuant to the Government’s Decree No. 120/2003/ND-CP of October 20, 2003 amending Article 9 of Decree No. 30/2002/ND-CP of March 26, 2002;

Pursuant to the Government’s Decree No. 49/2003/ND-CP of May 15, 2003 prescribing the functions, tasks, powers and organizational structure of the Ministry of Health;

The Ministry of Health hereby guides the work of healthcare for elderly people as follows:

I. GENERAL PROVISIONS

1. Elderly people to be given healthcare under this Circular are citizens of the Socialist Republic of Vietnam or elderly overseas Vietnamese and elderly foreigners living and working in Vietnam, who are aged full 60 or older. Old age is often accompanied with poor health and ailments; around 95% of elderly people are infected with various diseases. On average, an elderly person is infected with 2.69 diseases, mainly non-contagious chronic ones; therefore the earnest aspiration of elderly people is to live in good health and be given healthcare as well as medical examination and treatment when they get sick. Being a legitimate demand of elderly people, it requires the concern of various branches and levels as well as the whole society.

2. The elderly people shall be given primary healthcare as well as priority in medical examination and treatment at medical establishments.

3. The People’s Committees of different levels shall have to ensure the regime of healthcare for the elderly people in their respective localities. The health service shall have to take the professional and technical responsibility in healthcare for the elderly people.

II. MANAGEMENT OF THE HEALTH OF, AND PRIMARY HEALTHCARE FOR, ELDERLY PEOPLE

The People’s Committees and People’s Councils of all levels shall have to direct the health service to coordinate with the concerned branches in formulating and implementing plans on healthcare for elderly people in their respective localities according to the following requirements:

1. To organize the dissemination and popularization of contents on physical training, health improvement and prevention of diseases, especially diseases often seen in the elderly people, so that the elderly people can prevent diseases for themselves.

2. To organize health check-ups in order to compile records for monitoring the health of elderly people. To carry out health check-ups once a year and step by step set up a network of family doctors and at-home healthcare service for elderly people.

3. To organize the elders’ clubs in various forms such as light physical exercise clubs and outdoor health clubs. Depending on the conditions and requirements of elderly people, localities may organize various clubs for people infected with such chronic diseases as diabetes, asthma, hypentension, cardiovascular diseases, renal diseases, cataract, etc.

4. To prioritize investment in programs on community-based functional rehabilitation for disabled elders in order to help them prevent and rehabilitate from the sequelae of injuries, accidents or cerebral catastrophes, chronic diseases, occupational diseases, etc.

5. To organize a network of volunteers in order to provide healthcare for elderly people, especially poor and lonely people, at their homes. To encourage retired medical workers to join the contingent of volunteers or participate in training volunteers on necessary knowledge on healthcare for elderly people such as self-help in daily-life activities, especially for those who suffer from the sequelae of cardiovascular diseases or accidents, on social communications and medical self-care.

III. MEDICAL EXAMINATION AND TREATMENT FOR ELDERLY PEOPLE

1. To organize a network of medical examination and treatment for elderly people

a/ The Institute of Gerontology shall have the responsibilities:

- To organize the research into, and application of, scientific and technical advances in three domains: clinical gerontology, basic gerontology and social gerontology, and propose measures to raise the quality of healthcare for Vietnamese elders.

- To professionally and technically direct the healthcare for elderly people nationwide. To inspect the implementation of professional process and standards as well as the provision of instruments for geriatrics establishments of lower levels in order to ensure functional rehabilitation exercises for elderly people.

- To act as treatment establishment specialized in geriatric nosology.

- To coordinate with Hanoi Medical University and other medical workers’ training schools in conducting tertiary and post-graduate training on geriatric majors. To compile textbooks, professional training books and books on healthcare for elderly people.

b/ General hospitals of grade I and grade II: To set up geriatrics departments and arrange separate room consultation for elderly people at the consultation departments.

c/ Specialized hospitals (except pediatrics hospitals): To provide medical examination for elderly people at consultation departments; when elderly patients need to be hospitalized as in-patients, the hospitals must warmly receive and give whole-hearted care to them, not to let these patients share beds.

d/ Medical centers of urban districts, rural districts, provincial capitals and towns: To arrange beds for elderly patients at clinical departments and organize medical examinations for elderly people at consultation departments.

e/ Convalescence and functional rehabilitation hospitals should continue to be built and consolidated according to the provisions of the Health Minister’s Decision No. 966/BYT of May 30, 1999 guiding the operations of convalescence and functional rehabilitation hospitals; to arrange a rational number of hospital beds for the care of, and functional rehabilitation for, elderly patients. To coordinate with the Labor, War Invalids and Social Affairs service in implementing the regime of convalescence for elderly people with meritorious services to the country.

f/ Health stations of communes, wards and townships shall have to manage the health of, and give primary healthcare to, elderly people in their localities. In cases where disabled and lonely elders get sick but are unable to go for medical examination and treatment at designated places, the heads of the communal-level health stations shall send medical workers to give medical examination and treatment to such elderly people at their homes or report such to the local People’s Committees for organizing the sending of such patients to medical examination and treatment establishments.

2. Therapeutic work

- Medical examination and treatment for elderly patients shall be carried out according to the professional levels, except for emergency cases where patients shall be transferred to the nearest medical establishments.

- Medical examination and treatment establishments must prioritize the medical examination of elderly patients (after emergency cases).

- To step by step manage chronic diseases for elderly people according to programs and projects so as to be able to detect and timely handle abnormal developments. To work out plans on disease prevention and treatment for subjects infected with chronic diseases.

- To enhance the functional rehabilitation for elderly patients after treatment for acute diseases at hospitals and provide guidance on continued treatment at their families.

- To combine methods of therapy with traditional medicine with those with modern medicine. To develop therapeutic methods without using drugs for elderly patients, especially at grassroots medical establishments.

IV. FUNDING FOR PRIMARY HEALTHCARE AND MEDICAL EXAMINATION AND TREATMENT FOR ELDERLY PEOPLE

1. Funding for health check-ups, including the compilation of records for monitoring elderly people’s health and the organization of periodical health check-ups and primary healthcare for elderly people, shall be covered by localities.

2. Funding for medical examination and treatment:

a/ Expenses for medical examination and treatment for those who have compulsory health insurance cards or voluntary health insurance cards shall be covered by Social Insurance according to law provisions on health insurance.

b/ Expenses for medial examination and treatment for beneficiaries of the regime of medical examination and treatment for the poor shall be covered by the funds for medical examination and treatment for the poor under the Prime Minister’s Decision No. 139/2002/QD-TTg of October 15, 2002 on medical examination and treatment for the poor and Joint Circular No. 14/2002/TTLT-BYT-BTC of December 16, 2002 of the Ministry of Health and the Ministry of Finance guiding the implementation of this Decision.

c/ Elderly people aged 90 or older shall enjoy the health insurance regime prescribed in Circular No. 24/2003 of November 6, 2003 of the Ministry of Labor, War Invalids and Social Affairs guiding the implementation of the Government’s Decree No. 120/2003/ND-CP of October 20, 2003.

3. Those who do not have health insurance cards prescribed at Article 2 above shall have to bear medical examination and treatment expenses.

4. Domestic as well as foreign organizations and individuals and families of elderly people are encouraged to buy health insurance cards for elderly people.

5. Localities should set up healthcare funds for elderly people in order to render support for the healthcare as well as medical examination and treatment for elderly people.

V. IMPLEMENTATION ORGANIZATION

1. At provincial, district and communal levels, the boards for healthcare for elderly people, composing of leaders of the administrations as their heads, representatives of health services as their standing members and representatives of finance and labor, war invalids and social affairs services, other concerned branches, the Association of Elderly People, Red Cross Society, Fatherland Front, Peasants’ Association, and Women’s Union as their members, shall be set up to ensure and maintain healthcare for elderly people in localities. In order to unify healthcare activities, these boards should be integrated with the boards for primary healthcare in the localities.

2. The provincial/municipal Health Services shall have to advise the provincial/municipal People’s Committees on formulating plans on healthcare for elderly people in their respective provinces under the provisions of this Circular and to direct district- and communal-level medical establishments to give healthcare to elderly people in their respective localities.

3. The Therapy Department shall have to coordinate with the functional departments, the Health Ministry’s Inspectorate, the Institute of Gerontology and the concerned units in guiding, directing, examining and inspecting the implementation of this Circular.

4. The Center for Health Information and Education shall coordinate with the Institute of Gerontology in organizing the dissemination of the knowledge on healthcare for elderly people.

5. This Circular takes effect 15 days after its publication in the Official Gazette. In the course of implementation, if meeting with any problems, units and localities should report them to the Ministry of Health (the Therapy Department) for consideration and settlement or amendment and supplementation.

For the Minister of Health

Vice Minister
LE NGOC TRONG